AVMA GHLIT Family Group Life Insurance Plan Designed by veterinarians for veterinarians Available to Graduating Student Members v Insurance you can trust. Underwritten by New York Life Insurance Company (NY, NY 10010)
designed by veterinarians for veterinarians Valuable Benefits. Remarkable Service. Life sometimes throws you a curve at the most unexpected times. You can t always see what s coming around the bend. But with the American Veterinary Medical Association Group Health and Life Insurance Trust (AVMA GHLIT) behind you, you re prepared for whatever life may bring. With Life Insurance coverage from AVMA GHLIT, you re backed by the group purchasing power of thousands of veterinarians across the country and underwritten with your peers. The flexible plans were tailor made by veterinarians specifically designed for the unique needs of other doctors like you. Putting Your Needs First. Since 1957, the AVMA GHLIT has provided members with coverage you can trust. That s because AVMA members are more than just program participants they re in charge. Nine Trustees, all AVMA Members, and one AVMA Liaison Trustee, supervise the program and its professional operating staff and provide overall direction. In addition, the Trustees act as a Review Board, should a member ever experience a problem with the insurance program. You can think of it as having a Board of Directors that puts your needs first. The Program is designed to save members money. As a self-rated participating program, the charges to members are based on the claims experience of AVMA members and their families no other outside groups. And funds received in excess of those required to operate the Program are returned to participants in the form of lower costs or improved coverage. The Program is underwritten by New York Life Insurance Company, one of the industry s most respected names. New York Life Insurance Company (NY, NY 10010), the underwriter, has received the highest possible ratings for financial strength from some of the insurance industry s leading independent rating services including Moody s Investor Service (Aaa), Standard & Poor s (AAA), Fitch Ratings (AAA), and A.M. Best (A++).* the avma ghlit family group life insurance plan An affordable way to ensure your family s well-being. We know you understand the need to have life insurance to help replace the future income your family would lose at your death. But it can seem difficult and expensive to purchase enough protection, particularly if you ve shopped for life insurance as an individual purchaser. This is where your AVMA membership serves you well. Our AVMA Group Term Life/AD&D Plan offers you the opportunity for substantial coverage, at competitive group rates that may save you money. 2 You can apply for Family Group Term Life by itself or with the additional option of Large Scale Accidental Death and Dismemberment coverage. *Individual Third Party Ratings Reports (as of 7/7/10)
Most AVMA Members are eligible to apply. If you re an AVMA member under age 70 and reside in the United States, you re eligible to apply for the Group Term Life/AD&D Plan. Family group term life coverage You pay for pure protection. The AVMA Plan is designed to give you the most for your insurance dollar, because it s term insurance the kind so often recommended by many financial experts. There are no investment features or loan provisions that can mean higher premiums without any increase in protection. You can save even more if you re a Non-Smoker. If you have not smoked a cigarette in the last 12 months, you may qualify for a select Non-Smoker premium that is lower than our Smoker rates. You can apply for Member Coverage up to $100,000. Member coverage is available up to $100,000 in units of $10,000. Spouse/Domestic Partner Coverage is available up to $100,000. Coverage for your lawful spouse/domestic partner is available up to $100,000 in units of $10,000. Your spouse s/domestic partner s coverage may not be more than 100 percent of your own coverage. Coverage for you and your spouse/domestic partner remains level until age 75. It then reduces 50 percent and remains constant at that reduced amount until coverage ceases at age 80. You have an important Life Insurance Conversion Privilege. As a Member, you are entitled to convert your coverage to an individual life insurance policy* for up to the amount of insurance terminating, without regard to physical condition, when your coverage ceases for one of the following reasons: m You ve reached the age of 80, or m You re no longer a member of AVMA. Your Spouse/Domestic Partner and Dependent Children may also have a Conversion Privilege. If your Member life insurance terminates, and conversion is permissible, your insured dependents including your spouse/domestic partner and dependent children will also be entitled to convert to an individual policy* under the same terms. Additionally, dependent life insurance may be converted if it ceases due to termination of eligibility as a dependent. Additional member and dependent conversion options are explained in the Certificate of Insurance. All requests for conversions must be made within 31 days. * Without Waiver of Premium for disability or other additional benefit provisions. please note Term Life Exclusions and Limitations. m Suicide, within two years after a person s coverage becomes effective, is not covered. In that event, premiums paid for the person s coverage will be returned.** ** Missouri residents: Benefits will not be paid for death resulting from suicide within the first two years if New York Life can show that suicide was intended at the time of application. You can cover your Dependent Children, too. You may choose either $5,000 or $10,000 option for your Dependent Children. Each unmarried, dependent child from 14 days old to age 23 can be covered. 3
optional large scale accidental death & dismemberment coverage You can help protect both yourself and your spouse/domestic partner. A serious accident can happen anywhere, at any time. Although you can t completely eliminate the risk, you can help protect yourself against the financial impact which often can be substantial. You can choose the Maximum Benefit you wish to be paid. For both yourself and your spouse/domestic partner, you may select a Principal Sum the maximum benefit to be paid. Member Coverage is available with a Principal Sum of up to $200,000 in units of $10,000. Spouse/domestic partner coverage is available with a Principal Sum of up to $100,000 in units of $10,000. Your spouse s/domestic partner s coverage may not be more than your own coverage. You receive coverage for these serious accidents. Benefits are payable for the following losses if they result directly from and within 180 days after accidental injuries sustained while insured. Loss of Life Both hands, both feet or sight of both eyes One hand and one foot One hand or foot and sight of one eye One hand or foot or sight of one eye Benefit Principal Sum Principal Sum Principal Sum Principal Sum 1/2 of Principal Sum Loss of a hand or foot means it is completely severed through, or above the wrist or ankle joint. Loss of sight means total and irrecoverable loss. AD&D Exclusions and Limitations. Benefits are not paid for losses due to: m suicide or self-inflicted injuries (whether intentional or while insane)* m w a r m military service m pregnancy (or its termination) m or for losses due wholly or partly to disease or mental infirmity or treatment or operation for such disease/infirmity * Missouri residents: The exclusion for losses due to suicide or self-inflicted injury is not applicable to the injuries caused by an attempted suicide while insane. 4
Also, benefits are not payable for losses due to aviation activities other than flying solely as a passenger on a regularly scheduled commercial flight, on a franchise passenger route or on certain non-scheduled flights made solely for business reasons. If the same accident causes more than one loss, only the one largest benefit shown for any of the losses suffered is payable. FAMILY GROUP TERM LIFE AND OPTIONAL LARGE SCALE ACCIDENTAL DEATH & dismemberment coverage When your coverage becomes effective. In order to become insured, individuals must provide satisfactory evidence of insurability and pay the required premium. Insurance on you and your eligible approved dependents will take effect on the date coverage is approved by New York Life, provided: m the initial contribution is paid to the AVMA Group Health and Life Insurance Trust Office within 31 days of that date, and m any person to be insured is performing the normal activities of a person in good health of like age and sex on the date of approval. Your premium may be waived upon disability. If you become disabled before age 65 and remain so for six months, the AVMA Group Health and Life Insurance Trust will pay further premiums to continue any Family Group Term Life Insurance and Large Scale Accidental Death and Dismemberment coverages in-force when that disability began. Premiums will be paid by the Trust while you stay so disabled and until coverage would otherwise terminate due to age. To qualify for the Accelerated Death Benefit an individual must be insured under the AVMA Term Life Insurance Plan, under age 79, and diagnosed as having a life expectancy of 12 months or less. Proof of terminal illness will consist of a statement from the insured s physician and any other medical information that New York Life believes necessary to confirm the insured s status. If the insured qualifies, he or she will be paid, in a lump sum, 50 percent of the amount that would be payable 12 months after the date of approval of the request. Only one Accelerated Death Benefit will be made during the insured s lifetime and any benefit payable for loss of life will be reduced by the amount paid under the Accelerated Death Benefit. Receipt of Accelerated Death benefits may affect eligibility for public assistance programs and may be taxable. Insureds should consult with the appropriate social services agency and assistance should be sought from a qualified tax advisor (not available to residents of Massachusetts). Term Life Insurance Inflation Guard. An Inflation Guard feature has been added to the GHLIT Group Term Life Program for new or increased coverage effective on or after November 1, 2001. On May 1 for a period of 3 years beginning one year after the effective date of coverage, we will automatically increase your insurance amount by $10,000 for each $100,000 of coverage in-force, without medical underwriting, provided the total amount does not exceed the policy maximum of $1,000,000. For increases to be effective you must be under the age of 70, not disabled or eligible for waiver of premium on the May 1 of a scheduled Inflation Guard increase, and the additional premium must be paid. You can stop the increases at any time, by contacting the Trust Office in writing, or not remitting the premium for the Inflation Guard Increase. But once stopped, the automatic increase cannot be started again until new coverage has been medically underwritten and approved. This feature applies only to member coverage. Accelerated Death Benefit. This benefit is designed to provide terminally ill life insureds the option to have a portion of their life insurance benefit paid while they are still alive. The insured is then free to use that money any way he or she desires. 5
About continuation of insurance. New York Life cannot terminate coverage or change benefits or premiums on an individual basis; it may do so only on a class-wide basis. An example of class can be a group of insureds with the same age or gender. All insurance terminates when a member: m fails to pay insurance charges on time; m ceases to be an AVMA Member; m reaches age 80 for Family Group Life Insurance, and age 70 for Large Scale Accidental Death and Dismemberment Coverage; m if the Master Policy terminates. New York Life has agreed not to exercise its right to terminate the Master Policy as long as: (1) AVMA continues to sponsor only the New York Life Program and (2) participation in the plan exceeds 10,000 insured members. All dependent coverage terminates: m for spouse upon divorce/or termination of domestic partnership; m for a dependent child when he or she becomes self-supporting, marries or reaches age 23; m upon termination of member coverage except for death or reaching the limiting age. Your death benefits are paid directly to your beneficiary. Death benefits for you are paid to the beneficiary you name. All other benefits, including benefits for all losses suffered by your spouse/domestic partner, are paid to you or your estate. You will receive a separate Certificate. Each insured member will receive a Certificate of Insurance evidencing coverage which is provided under Group Policy Form GMR. For NY Residents Only Important Replacement Information It may not be in your best interest to replace existing life insurance policies or annuity contracts in connection with the purchase of a new life insurance policy, whether issued by the same or different insurance company. A replacement will occur if, as part of your purchases of a new life insurance policy, existing coverage has been, or is likely to be, lapsed, surrendered, forfeited, assigned, terminated, changed or modified into paid-up or other form of benefits, loaned against or withdrawn from, reduced in value by use of cash values or other policy values, changed in the length of time or in the amount of insurance that would continue or continued with a stoppage or reduction in the amount of premium paid. Prior to completing a replacement transaction, you may want to contact the insurance company or agent who sold you the life insurance or annuity contract that will be replaced, to help you decide whether the replacement is in your best interest. 6
rates FAMILY GROUP LIFE INSURANCE Current monthly RATES* MEMBER $100,000 to $1,000,000 ($10,000 Units). Charges shown are for $10,000 and are based on member s age at issue and each November 1. SPOUSE/DOMESTIC PARTNER $100,000 to $500,000 ($10,000 Units), but not more than 100% of the amount for the member. Charges shown are for $10,000 and are based on spouse s/domestic partner s age at issue and each November 1. CHILDREN $5,000 or $10,000 LARGE SCALE ACCIDENTAL DEATH AND DISMEMBERMENT current monthly RATES* $10,000 to $200,000 ($10,000 Units) for member and up to $100,000 for spouse/domestic partner but not exceeding member coverage. $.60 for each $10,000. *New York Life has the right to change rates on a class-wide basis. TERM LIFE monthly RATES* Member or Spouse/Domestic Partner coverage for each $10,000 Attained Age Smoker $100,000 or over Non-Smoker $100,000 or over Under 30.58.43 30 34.71.53 35 39.90.68 40.97.73 41 1.05.80 42 1.14.88 43 1.26.97 44 1.39 1.08 45 1.51 1.18 46 1.64 1.29 47 1.79 1.41 48 1.94 1.55 49 2.12 1.69 50 2.34 1.89 51 2.59 2.11 52 2.86 2.34 53 3.15 2.60 54 3.47 2.88 55 3.85 3.21 56 4.28 3.59 57 4.74 4.00 58 5.27 4.46 59 5.86 4.98 60 6.43 5.54 61 7.07 6.17 62 7.76 6.86 63 8.51 7.59 64 9.33 8.40 65 10.17 9.15 66 11.09 9.98 67 12.11 10.90 68 13.24 11.91 69 14.47 13.03 Children ($5,000 per child) $1.00 for one or more children or ($10,000 per child) $2.00 for one or more children. 7
important notice How New York Life Underwrites Your Request for AVMA GHLIT Coverage Information regarding insurability will be treated as confidential. In considering your request for standard or preferred rates, we will rely on the medical information you provide, and on the information you authorize us to obtain from your doctor, other medical practitioners and facilities, other insurance companies to which you have applied for insurance and MIB, Inc. (formerly known as Medical Information Bureau). New York Life will not disclose such information to anyone except those you authorize or where required or permitted by law. New York Life may use or disclose information as described in the HIPAA Notice of Privacy Practices in Protected Health Information. We may make a brief report to MIB; however, we will not disclose our underwriting decision. Information in our files may be seen by New York Life and Plan Administrator employees, but only on a need to know basis in considering your request. Upon receipt of all requested information we will make a determination as to whether your request for coverage can be approved for standard rates. MIB is a nonprofit, membership organization of insurance companies that operates an information exchange on behalf of its members. When you apply for insurance or submit a claim for benefits to a MIB member company, medical or non-medical information may be given to the Bureau, which may then be furnished to member companies. If we cannot provide you with standard rates, we will tell you why. If you feel our information is inaccurate, you will be given a chance to correct or complete the information in our files. Upon written request to New York Life or MIB, you will be provided with non-medical information, generally medical information will be given either directly to the proposed insured or to a medical professional designated by the proposed insured. Your request is handled in accordance with the Fair Credit Reporting Act Procedures. If you question the accuracy of the information provided by MIB, you may contact MIB and seek a correction. MIB s information office is: MIB, Inc. 50 Braintree Hill Park Suite 500 Braintree, MA 02184-8734 For Canadian residents, the address is: 330 University Avenue, Suite 403 Toronto, Canada M5G IR7 MIB can be reached toll free in the U.S.A at 866-692-6901. For hearing impaired, TTY 866-346-3642. Canadian residents can call 416-597-0590. Information for consumers about MIB may be obtained on its website www.mib.com. For NM Residents, PROTECTED PERSONS (1) have a right of access to certain CONFIDENTIAL ABUSE INFORMATION (2) we maintain our files and they may choose to receive such information directly. You have the right to register as a PROTECTED PERSON by sending a signed request to the Administrator at the address listed on the application. Please include your full name, date of birth and address. (1) PROTECTED PERSON means a victim of domestic abuse who has notified us that he/she is or has been a victim of domestic abuse; and who is an insured or prospective insured. (2) CONFIDENTIAL ABUSE INFORMATION means information about: acts of domestic abuse of abuse status; the work or home address or telephone number of a victim of domestic abuse; or the status of an applicant or insured as family member, employer or associate of a victim of domestic abuse or a person with whom an applicant or insured is known to have a direct, close personal, family or abuse-related counseling relationship. If we can provide the coverage you requested, we will inform you as to when such coverage will be effective. Under no circumstances will coverage be effective prior to this date. Payment of a premium contribution with your application does not mean that there is any insurance in force before the effective date as determined by New York Life. NEW YORK LIFE INSURANCE COMPANY Rev 1/09 This material briefly describes the provisions of Master Policy G-14884/Face policy form GMR issued to the Trustees of the AVMA GHLIT. For complete details on your coverage please see your Certificate of Insurance. Broker/Administrator: HealthPlan Services 3501 Frontage Road Tampa, FL 33607 Underwritten by: New York Life Insurance Co. 51 Madison Avenue New York, NY 10010 Claims Administrator: UMR, Inc. 233 N. Michigan Ave., Ste. 1050 Chicago, IL 60601 15110T 7395 4/11 A Membership Service of the American Veterinary Medical Association The AVMA Group Health and Life Insurance Trust 3501 Frontage Road Tampa, FL 33607 1.800.621.6360 www.avmaghlit.org